From a colleague and friend: You mentioned black cohosh being safe. You can look that one up, but I remember reading a study that analyzed many black cohosh products and found a high percentage contained zero black cohosh. I also recall other dangers of taking unregulated supplements. I worked on a popular herbal supplement once.  It caused liver damage and cancer. I published a paper about them damaging DNA. A major problem is that such herbal products are not analyzed for content or, even more important, for identity. We saw case reports at alkaloid conferences of children who had been given herbal teas and died. I’ll never forget an autopsy photo of a liver from a small child that looked like end-stage liver failure of an alcoholic, although probably far worse. Analysis showed that the herb was misidentified or substituted. Sometimes the herbs were collected according to common name, which can vary from country to country.

I wouldn’t touch most herbal supplements with a ten-foot pole. As you have mentioned, it’s always good to have a USP label. Fat chance of that for black cohosh. Of course USP-approved herbal supplements could be possible. It would require balancing and mixing various strength raw materials followed by careful analysis. But we shouldn’t “hold our breath” expecting that to happen.